The echinocandin caspofungin impairs the innate immune mechanism against Candida parapsilosis.

Since caspofungin inhibits fungal cell wall beta-glucan synthesis and the fungal cell wall plays an important role in the recognition of Candida by phagocytic cells, we studied phagocytosis in the presence of caspofungin. The aim of this work was to investigate the effect of pre-treatment of Candida parapsilosis with caspofungin on phagocytic mechanisms (opsonisation, oxidative burst, phagocytosis and killing). C. parapsilosis grown in the presence of caspofungin at concentrations above the minimal inhibitory concentration (MIC) were more difficult to opsonise and to phagocytose. C. parapsilosis exposed to any concentration of caspofungin below and above the MIC was more difficult to kill. Caspofungin-treated C. parapsilosis impaired the oxidative burst. Overall, it appears that caspofungin treatment of C. parapsilosis alters the capacity of polymorphonuclear leukocytes to phagocytose and delays killing of the organism. This may allow C. parapsilosis to persist in tissues.